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https://www.readbyqxmd.com/read/27922949/the-neurological-safety-of-an-epidurally-administered-lipo-pge1-agonist-in-rats
#1
Eunjoo Choi, Sun Min Im, Hyung-Seok Yoo, Francis Sahngun Nahm, Yang Hyun Kim, Gheeyoung Choe, Pyung Bok Lee
BACKGROUND AND OBJECTIVE: Liposomal prostaglandin E1 (Lipo-PGE1) can inhibit platelet aggregation and vasodilatation and has been found to be therapeutic in ischemia and spinal diseases including stenosis. However, the neurologic safety of epidural administration of lipo-PGE1 requires further study. We investigated the neurotoxicity of epidurally administered lipo-PGE1 agonist in rats. METHODS: Twenty-seven rats were randomly divided into three groups: Epidural isotonic sodium chloride solution administration (negative control, group N, n = 9); epidural lipo-PGE1 agonist (group L, n = 9); and epidural alcohol (positive control, group A, n = 9)...
December 5, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27921214/external-validity-of-the-chiari-severity-index-and-outcomes-among-pediatric-chiari-i-patients-treated-with-intra-or-extra-dural-decompression
#2
Jared M Pisapia, Maxwell B Merkow, Danielle Brewington, Rosemary E Henn, Leslie N Sutton, Phillip B Storm, Gregory G Heuer
INTRODUCTION: Chiari malformation type-1 (CM-1) may be treated by intradural (ID) or extradural (ED) posterior fossa decompression, although the optimal approach is debated. The Chiari Severity Index (CSI) is a pre-operative metric to predict patient-defined improvement after CM-1 surgery. In this study, we evaluate the results of ID versus ED decompression and assess the external validity of the CSI. METHODS: We performed a retrospective cohort study of pediatric CM-1 patients undergoing decompression at a single academic children's hospital...
December 5, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27921035/genetics-underlying-an-individualized-approach-to-adult-spinal-disorders
#3
REVIEW
Corey T Walker, Phillip A Bonney, Nikolay L Martirosyan, Nicholas Theodore
Adult spinal disorders are a significant cause of morbidity across the world and carry significant health and economic burdens. Genetic predispositions are increasingly considered for these conditions and are becoming understood. Advances in molecular technologies since the mid-1990s have made possible genetic characterizations of these diseases in many populations, and recent findings have provided insight into the underlying pathophysiologic mechanisms. These studies have made clear the genetic heterogeneity producing clinical phenotypes and suggest that individualized treatments are possible in the future...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27920716/acute-clinical-worsening-after-steroid-administration-in-cervical-myelitis-may-reveal-a-subdural-arteriovenous-fistula
#4
Silvia Rain, Jan Udding, Daniel Broere
Subdural arteriovenous fistula (SDAVF) is a rare condition characterized by clinical manifestations ranging from mild bilateral sensory deficits to quadriplegia. The diagnosis is often delayed due to unspecific neurological symptoms, initially diagnosed as polyneuropathy or myelopathy. The diagnosis can be delayed for as long as 1-15 years. The following report describes a cervical SDAVF case initially misdiagnosed as myelitis transversa and treated with intravenous steroids. A 56-year-old male presented with sensory deficits and mild leg and right arm weakness...
September 2016: Case Reports in Neurology
https://www.readbyqxmd.com/read/27920210/neurosarcoidosis-unusual-presentations-and-considerations-for-diagnosis-and-management
#5
Walid Radwan, Brandon Lucke-Wold, Ibrahim Ahmed Robadi, Kymberly Gyure, Thomas Roberts, Sanjay Bhatia
BACKGROUND: Sarcoidosis is a chronic, multisystem disease characterised by non-necrotising granulomatous inflammation of unknown aetiology. Most commonly, the lungs, lymph nodes, skin and eyes are affected in sarcoidosis; however, nervous system involvement occurs in approximately 5%-15% of cases. Any part of the nervous system can be affected by sarcoidosis. CASES: Herein we describe three unusual patient presentations of neurosarcoidosis, one with optic neuritis, a second with hydrocephalus and a third with cervical myelopathy...
December 5, 2016: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/27919200/bony-ankylosis-of-the-facet-joint-of-the-cervical-spine-in-rheumatoid-arthritis-its-characteristics-and-relationship-to-the-clinical-findings
#6
Haku Iizuka, Yoichi Iizuka, Koichi Okamura, Yukio Yonemoto, Tokue Mieda, Kenji Takagishi
OBJECTIVES: The purpose of this study was to clarify the characteristics of bony ankylosis of the facet joint of the cervical spine in RA patients who required cervical spine surgery, and its relationship to the clinical findings. METHODS: Eighty consecutive RA patients with cervical spine disorder who received initial surgery were reviewed. The occurrence of bony ankylosis of the facet joint of the cervical spine was investigated using computed tomography (CT) before surgery...
December 6, 2016: Modern Rheumatology
https://www.readbyqxmd.com/read/27917507/evidence-of-a-genomic-insertion-in-intron-2-of-sod1-causing-allelic-drop-out-during-routine-diagnostic-testing-for-canine-degenerative-myelopathy
#7
M E Turba, R Loechel, E Rombolà, G Gandini, F Gentilini
Degenerative myelopathy is a severe and progressive neurodegenerative disease and, in the majority of breeds, is associated with the c.118G>A substitution in exon 2 of the canine superoxide dismutase 1 (SOD1) gene. Our laboratories have been engaged in determining the cause of many discordant findings between the parental and the offspring genotypes found by different laboratories. In both cases, the discordant findings refer to actual heterozygous dogs that had been typed as homozygous for the variant allele...
December 4, 2016: Animal Genetics
https://www.readbyqxmd.com/read/27917370/multiple-myeloma-like-spinal-mri-findings-in-skeletal-fluorosis-an-unusual-presentation-of-fluoride-toxicity-in-human
#8
Javed Ahsan Quadri, Mohd Meraj Alam, Saba Sarwar, Ashraf Ghanai, A Shariff, Taposh K Das
Endemic fluorosis is a worldwide environmental problem due to excessive fluoride, commonly due to increased drinking water fluoride levels but sometimes due to other sources such as food with high fluoride content. In India, 21 of the 35 states are known to have health problems associated with fluoride toxicity. The present report is a case of a 50-year-old female who was seen with progressive spinal complications and a MRI of the spine suggestive of multiple myeloma. The MRI of the lumbosacral spine showed a diffuse and heterogeneous marrow signal of the lower dorsal and lumbosacral vertebrae...
2016: Frontiers in Oncology
https://www.readbyqxmd.com/read/27917333/extensive-calcification-of-the-ligamentum-flavum-causing-cervical-myelopathy-in-a-caucasian-woman
#9
Milaine Roet, Jochem K H Spoor, M de Waal, Max J Kros, Sanjay B Harhangi, Ruben Dammers
Calcification of the ligamentum flavum (CLF) can cause myelopathy due to spinal cord compression. Only several cases in Caucasian patients have been described. Neurological deterioration can only be stopped by surgical decompression. We report a 63-year-old Caucasian woman presenting with progressive pins-and-needles sensations in both hands, worsened by painful paresthesia in both lower extremities. MRI showed a dorsal compressive mass extending from C2 to Th3 vertebrae with myelopathy at the level of C6. A laminectomy was performed, which improved clinical symptoms...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27913626/ring-enhancing-spinal-cord-lesions-in-neuromyelitis-optica-spectrum-disorders
#10
Nicholas L Zalewski, Padraig P Morris, Brian G Weinshenker, Claudia F Lucchinetti, Yong Guo, Sean J Pittock, Karl N Krecke, Timothy J Kaufmann, Dean M Wingerchuk, Neeraj Kumar, Eoin P Flanagan
OBJECTIVE: We assessed the frequency and characteristics of ring-enhancing spinal cord lesions in neuromyelitis optica spectrum disorder (NMOSD) myelitis and myelitis of other cause. METHODS: We reviewed spinal cord MRIs for ring-enhancing lesions from 284 aquaporin-4 (AQP4)-IgG seropositive patients at Mayo Clinic from 1996 to 2014. Inclusion criteria were as follows: (1) AQP4-IgG seropositivity, (2) myelitis attack and (3) MRI spinal cord demonstrating ring-enhancement...
December 2, 2016: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/27909657/remote-cervical-pseudomeningocele-following-anterior-cervical-corpectomy-and-fusion-report-of-a-case-and-review-of-the-literature
#11
Abolfazl Rahimizadeh, Housain Soufiani, Shaghayegh Rahimizadeh
Iatrogenic cervical pseudomeningocele is a rare event and majority are located posteriorly as a delayed complication of inadvertent dural tear after decompressive laminectomy. However, iatrogenic anterior cervical pseudomeningocele subsequent to discectomy or corpectomy is a rare pathology. The time necessary for formation of pseudomeningocele varies and depend on the width of the dural tear and the flow of cerebrospinal fluid leakage. Large tears with high CSF flow usually result in early collection of the cerebrospinal fluid in anterior compartment of the neck designated acute pseudomeningoceles...
2016: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/27909653/magnetic-resonance-imaging-of-the-cervical-spine-under-represents-sagittal-plane-deformity-in-degenerative-myelopathy-patients
#12
Douglas S Weinberg, Arunit J Chugh, Jeremy J Gebhart, Jason D Eubanks
BACKGROUND: In treating patients with cervical myelopathy, surgical approach may be dictated by sagittal balance, highlighting the need for accurate pre-operative assessment. Magnetic Resonance Imaging (MRI) is widely-recognized for its utility in the diagnosis and surgical planning of cervical myelopathy. Plain radiographs (X-rays) are a reliable tool to assess bony alignment. However, they may not always be included in standard pre-operative evaluation, especially in an era of restricted payer-environments...
2016: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/27909651/hybrid-decompression-and-fixation-technique-for-the-treatment-of-multisegmental-cervical-spondylotic-myelopathy
#13
Barón Zárate-Kalfopulos, Walter Araos-Silva, Alejandro Reyes-Sánchez, Luis Miguel Rosales-Olivarez, Armando Alpizar-Aguirre, Francisco Lopez Melendez
BACKGROUND: Cervical spondilotic myelopathy (CSM) is defined as the compromise of the spinal cord due to degenerative changes of the cervical spine. It is the most common cause of spinal cord dysfunction in patients over 55 years. An early surgical management it is paramount to achieve better neurological outcome. There is still controversy regarding the appropriate surgical treatment for multisegmental CSM involving three or more levels. The hybrid decompression and fixation technique combines one or two level corpectomy and a single level discectomy in order to obtain optimum decompression and fixation in patients with multilevel cervical myelopathy...
2016: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/27907060/amplitude-of-low-frequency-fluctuation-alff-in-the-cervical-spinal-cord-with-stenosis-a-resting-state-fmri-study
#14
Xiaojia Liu, Wenshu Qian, Richu Jin, Xiang Li, Keith Dk Luk, Ed X Wu, Yong Hu
Cervical spondylotic myelopathy (CSM) is a common spinal cord dysfunction disease with complex symptoms in clinical presentation. Resting state fMRI (rsfMRI) has been introduced to study the mechanism of neural development of CSM. However, most of those studies focused on intrinsic functional connectivity rather than intrinsic regional neural activity level which is also frequently analyzed in rsfMRI studies. Thus, this study aims to explore whether the level of neural activity changes on the myelopathic cervical cord and evaluate the possible relationship between this change and clinical symptoms through amplitude of low frequency fluctuation (ALFF)...
2016: PloS One
https://www.readbyqxmd.com/read/27904963/10-year-follow-up-after-implantation-of-the-bryan-cervical-disc-prosthesis
#15
Joost Dejaegher, Joris Walraevens, Johannes van Loon, Frank Van Calenbergh, Philippe Demaerel, Jan Goffin
PURPOSE: Cervical arthroplasty is being used as an alternative for cervical fusion, but long-term follow-up results have rarely been reported. In this paper, we present 10-year follow-up results after implantation of the Bryan Cervical Disc Prosthesis in a single center. METHODS: 89 patients underwent implantation of a single-level Bryan Cervical Disc Prosthesis to treat radiculopathy and/or myelopathy. Clinical (Neurological Success, Neck Disability Index (NDI), Neck- and Arm-Pain, and SF-36) and radiological follow-up was prospectively organized up to 10 years after surgery...
November 30, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27904722/comparison-between-radiological-and-clinical-outcomes-of-laminoplasties-with-titanium-miniplates-for-cervical-myelopathy
#16
Jong-Hwa Park, Jae-Sung Ahn, Ho-Jin Lee, Byung-Kon Shin
BACKGROUND: Laminoplasty is a surgical procedure frequently performed for cervical myelopathy. We investigated correlations between changes in the anteroposterior diameter (APD) of the spinal canal, spinal canal area (SCA), and laminar angle (LA) and clinical outcomes of laminoplasty. METHODS: Of the 204 cervical myelopathy patients who underwent laminoplasty from July 2010 to May 2015, 49 patients who were evaluated with pre- and postoperative computed tomography of the cervical vertebrae were included...
December 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27902623/ossification-of-the-posterior-atlantoaxial-membrane-associated-with-atlas-hypoplasia-a-case-report
#17
Yichen Meng, Dongxiao Zhou, Rui Gao, Jun Ma, Ce Wang, Xuhui Zhou
RATIONALE: Hypoplasia with an intact posterior arch of the atlas and ossification of the posterior atlantoaxial membrane (PAAM) are individually rare. PATIENT CONCERNS: The patient presented with a 6-month history of progressive weakness and paresthesia of his lower extremities. DIAGNOSES: Cervical myelopathy resulting from atlas hypoplasia and ossification of the posterior atlantoaxial membrane. INTERVENTIONS: Laminectomy of the atlas with duroplasty...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27899230/experimental-zika-virus-infection-induces-spinal-cord-injury-and-encephalitis-in-newborn-swiss-mice
#18
Natália C C A Fernandes, Juliana S Nogueira, Rodrigo A Réssio, Cinthya S Cirqueira, Lidia M Kimura, Karolina R Fernandes, Mariana S Cunha, Renato P Souza, Juliana M Guerra
A widespread epidemic of Zika virus (ZIKV) infection was reported in 2015 in South and Central America, with neurological symptons including meningoencephalitis and Guillain-Barré syndrome in adults, besides an apparent increased incidence of microcephaly in infants born to infected mothers. It is becoming a necessity to have a trustworthy animal model to better understand ZIKV infection. In this study we used newborn white Swiss mice as a model to investigate the ZIKV strain recently isolated in Brazil. ZIKV was inoculated via intracerebral and subcutaneous routes and analysed through gross histopathology and immunohistochemistry...
November 26, 2016: Experimental and Toxicologic Pathology: Official Journal of the Gesellschaft Für Toxikologische Pathologie
https://www.readbyqxmd.com/read/27898600/is-it-necessary-to-extend-a-multilevel-posterior-cervical-decompression-and-fusion-to-the-upper-thoracic-spine
#19
Gregory D Schroeder, Christopher K Kepler, Mark F Kurd, Loren Mead, Paul W Millhouse, Priyanka Kumar, Kristen Nicholson, Christie Stawicki, Andrew Helber, Daniella Fasciano, Alpesh A Patel, Barret I Woods, Kris E Radcliff, Jeffery A Rihn, D Greg Anderson, Alan S Hilibrand, Alexander R Vaccaro
STUDY DESIGN: A retrospective cohort analysis. OBJECTIVE: The aim of this study was to determine if there is a difference in the revision rate in patients who undergo a multilevel posterior cervical fusions ending at C7, T1, or T2-T4. SUMMARY OF BACKGROUND DATA: Multilevel posterior cervical decompression and fusion is a common procedure for patients with cervical spondylotic myelopathy, but there is little literature available to help guide the surgeon in choosing the caudal level of a multilevel posterior cervical fusion...
December 1, 2016: Spine
https://www.readbyqxmd.com/read/27898552/a-young-woman-with-numbness-in-her-feet
#20
Daniel Pavlik, Michael Huber, Melissa Justice
This article describes a young, otherwise healthy woman who presented to the ED with numbness in her feet and was discharged. Twenty-four hours later, she returned because of difficulty walking; in 48 hours she could not walk without assistance. Although Guillain-Barré syndrome was suspected initially, the patient's weakness, sensory loss, and autonomic dysfunction eventually were diagnosed as transverse myelitis, a myelopathy often associated with infectious or autoimmune diseases. The article describes the presentation, diagnostic evaluation and criteria, treatment, and prognosis of transverse myelitis...
December 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
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